Disasters claimed the greatest number of lives worldwide in 2010—more than any other single-year period in the last several decades. In just Haiti alone, the death toll was estimated at 230,000, although the actual number may never be known. The variety, frequency and complexity of these events will continue to increase, as we live in a more sophisticated and interdependent world, and countries must prepare for this.
The foreign medical and rescue teams that arrived quickly in Haiti following the earthquake did save lives and prevented serious complications. However, this was not always the case with those who arrived later, nor has it always been true in other disasters, where medical teams arrived with sound technical skills but were not self-sufficient in terms of food, water, shelter or supplies. In the chaos of the first few weeks, the government may have been unaware of their presence. These are serious challenges for the Health Cluster and raise the imperative need for international guidelines for a more organized response.
At one point, the global Health Cluster coordinated the work of more than 400 health actors in Haiti. Many skill sets were needed to rise to this challenge, from managers to epidemiologists to information specialists to experts in media relations, to name just a few. The international pool of experts (already in short supply for an emergency of this magnitude) was further reduced by the need to speak French (which excluded many highly skilled professionals in Latin America and the Caribbean). In a global marketplace like post-earthquake Haiti, international humanitarian agencies competed fiercely for available talent, with the highest bidder often winning.
Cholera made a staggering resurgence in Haiti in 2010. Providing access to health care was a challenge in a country where less than 40% of the population had access to health care before the earthquake and where control of an epidemic depended on access to safe drinking water, basic sanitation and proper hygiene, all in short supply in Haiti.
The complete destruction of a health facility is a worst case scenario. But even hospitals that are unable to provide health care due to far less dramatic reasons leave an average of 200,000 people without access to health services. The loss of emergency services further reduces the chance to save lives. This should be cause enough to make the necessary investment to safeguard these critical facilities. Stringent building codes in Chile should help reduce the chance of collapsed structure in future earthquakes.
The aftermath of a disaster does not begin and end in any one year. Likewise, the availability of relief funding can also cross calendar years—and with positive outcomes. The generous funding for the response to the A (H1N1) pandemic in 2009 enabled activities to continue into 2010, helping to mainstream pandemic preparedness into routine health disaster management and to better organize countries to face other disasters.
Establishing strong partnerships with and among the global network of multisectoral actors is critical in today’s humanitarian response landscape, both within and outside the health sector. Universities, regional coordination networks and regional disaster institutions were just a few of the agencies with whom coordination and collaboration were strengthened in 2010. The strong and rapid response to Hurricane Tomas in Eastern Caribbean countries was a tangible outcome of these improvements.
The health crisis caused by the A (H1N1) pandemic was barely subsiding in the Americas when earthquakes in Haiti and Chile propelled the global community into non-stop action. Response and recovery activities were still underway when the 2010 Caribbean hurricane season began. Then, in mid-season, the outbreak of cholera caused another shift in attention. An effective response to emergencies and disasters is contingent on a well-prepared health sector. Is sufficient attention and funding being directed to preparedness issues? Is the health sector itself as prepared as possible?
With the endorsement in 2010 by the highest level health authorities of Canada, the U.S. and Latin America and the Caribbean, the health sector became the first sector (among those contributing to the Hyogo Framework for Action for building disaster resilience) to have developed a Regional Plan of Action—in this case for safe hospitals. With baseline data established, countries are now set to monitor their progress, using selfassessment tools to evaluate preparedness and mitigation improvements and an online database that tracks the results of the application of the Hospital Safety Index.
Social media and networking are gaining a growing place in emergencies and we can no longer afford to ignore their impact. More than 770 people follow PAHO’s Emergency Operations Center Twitter account and a new Spanish-language Facebook page is generating quite a dialogue. PAHO’s blog on cholera was the Organization’s most widely read. Today, almost 80 million people in the Americas use Facebook and another 40 million have Twitter accounts (in 2009 the figure was 3.5 million). The health disaster community must harness this power.
Regional Office of the World Health Organization